Provider Demographics
NPI:1356823314
Name:SENNETT, NICOLE R (FNPC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:R
Last Name:SENNETT
Suffix:
Gender:
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 468
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-0468
Mailing Address - Country:US
Mailing Address - Phone:207-858-8358
Mailing Address - Fax:207-474-9261
Practice Address - Street 1:46 FAIRVIEW AVE STE 225
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1481
Practice Address - Country:US
Practice Address - Phone:207-474-6265
Practice Address - Fax:207-474-8365
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP211389363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner